A 37 year old woman with a one-year history of recurrent episodes of urticaria accompanied by arthralgia and arthritis involving the hands and ankles. Physical examination showed several urticarial wheals at different stages of evolution and some light brown macules (which persisted after the wheals had disappeared) scattered on the whole cutaneous surface.
Histological examination of a skin biopsy was consistent with a leukocytoclastic vasculitis. Laboratory examinations revealed the presence of an IgA monoclonal gammopathy (1200mg/dl - normal range 60-400mg/dl) with lambda light chain isotype, a homogeneous pattern of ANA on HEp-2 cells, high titres of IgG anticardiolipin autoantibodies but no hypo-complementemia.
No clinical or laboratory evidence of myeloproliferative or connective tissue diseases was found.
Treatment with colchicine was instituted with good results.